Schmidt R M
Zentralbl Neurochir. 1979;40(3):185-96.
In this work, changes in the cerebrospinal fluid in acute and chronic polyneuritis as well as in the Guillan-Barré-Strohl syndrome are discussed and and it is pointed out that a specific coordination of the inflammatory cerebrospinal fluid syndromes to certain pathogens or noxae cannot be made. For the differentiation of the Guillain-Barré-Strohl syndrome and existence of increased gamma-globulin bands with identical mobility in the serum is pointed out. In myelitic disease pictures, acute and chronic cerebrospinal fluid syndromes are distinguished also in the cerebrospinal fluid according to the clinical course; regular changes, however, cannot be derived. Syphilitic cerebrospinal-fluid syndromes can easily be differentiated by their immunoactive findings. In multiple sclerosis, we distinguish between typical and atypical changes in the cerebrospinal fluid. Above all, the oligoclonal bands, i. e. the discontinuous proceeding of the gamma-globulin zone and the existence of several bands in the agar gel electrophoresis, play an essential role. In 95 per cent of the cases, oligoclonal bands can be shown. There are no greater differences with respect to oligoclonal bands between intermittent and chronic-progressive courses. For the differential diagnosis of haemorrhagic syndromes, the cerebrospinal fluid cell picture can make a considerable contribution. Macrophages loaded with erythrocytes indicate that a haemorrhage occurred 12 to 18 hours before; macrophages loaded with haemosiderin indicate a haemorrhage that occurred 6 to 8 days before; and macrophages loaded with erythrocytes and haemosiderin indicate a seeping haemorrhage or an event that occurred several times. The Nonne-Froin syndrome indicates a massive protein increase often with a regular or only slightly increased number of cells. The importance of the Queckenstedt tests is pointed out. A particular role is played by meningitis carcinomatosa et sarcomatosa with the demonstration of a great number of tumour cells.
在这项研究中，讨论了急性和慢性多发性神经炎以及吉兰 - 巴雷 - 施特罗尔综合征患者脑脊液的变化，并指出炎症性脑脊液综合征与某些病原体或有害物质之间不存在特定的对应关系。文中指出，对于吉兰 - 巴雷 - 施特罗尔综合征的鉴别诊断以及血清中具有相同迁移率的γ - 球蛋白带的存在情况。在脊髓疾病中，根据临床病程，急性和慢性脑脊液综合征在脑脊液中也可区分，但无法得出规律性变化。梅毒性脑脊液综合征可通过其免疫活性结果轻松鉴别。在多发性硬化症中，我们区分脑脊液中的典型和非典型变化。最重要的是，寡克隆带，即γ - 球蛋白区的不连续电泳条带以及琼脂凝胶电泳中多条带的存在，起着至关重要的作用。在95%的病例中可显示寡克隆带。间歇性病程和慢性进行性病程在寡克隆带方面没有太大差异。对于出血性综合征的鉴别诊断，脑脊液细胞图像可提供重要帮助。充满红细胞的巨噬细胞表明出血发生在12至18小时前；充满含铁血黄素的巨噬细胞表明出血发生在6至8天前；而充满红细胞和含铁血黄素的巨噬细胞表明有渗血或多次出血事件。诺内 - 弗罗因综合征表明蛋白质大量增加，通常细胞数量正常或仅略有增加。文中指出了奎肯施泰特试验的重要性。癌性和肉瘤性脑膜炎中出现大量肿瘤细胞起着特殊作用。
